Glassman Steven D, Schwab Frank, Bridwell Keith H, Shaffrey Christopher, Horton William, Hu Serena
Leatherman Spine Center, Louisville, KY 40202, USA.
Spine J. 2009 Apr;9(4):317-22. doi: 10.1016/j.spinee.2008.06.450. Epub 2008 Sep 6.
Health-related quality-of-life (HRQOL) measures are being used more frequently in the evaluation of the adult deformity patient. This is due in part to the validation of the deformity-specific Scolios Research Society-22 (SRS-22). Hence, relationships between HRQOL outcomes and traditional measures of success such as deformity correction, fusion healing, and complications are being established.
To examine the pattern of HRQOL outcome responses after adult deformity surgery.
Analysis of prospective multicenter cohort.
Two hundred and eighty-three adult deformity patients with preoperative, 1-, and 2-year postoperative outcome measures.
SRS-22, Short Form-12 (SF-12), Oswestry Disability Index (ODI), and back and leg pain numeric rating scale scores.
Preoperative versus postoperative health status measures were evaluated by matched-pairs sample t test statistics and post hoc analysis of variance (ANOVA) findings.
SRS-22 improved from a mean 3.03 points at baseline to 3.21 points at 6 months, 3.71 points at 1 year, and 3.70 points at 2 years post-op. Mean ODI score was 37.0 points pre-op and improved to 27.0 points at 6 months, and 22.8 points at 1 and 2 years post-op. Mean SF-12 physical component score was 33.7 points at baseline, improving to 36.9 points at 6 months, 40.6 points at 1 year, and 40.5 points at 2 years post-op. Paired samples analysis comparing 6-month and 1-year post-op scores showed deterioration for numeric rating scale leg pain (p=0.05). There was a trend for improvement in SF-12 physical component score (p=0.06). Significant improvement between 6 months and 1 year post-op was noted for ODI (p=0.02) and SRS total score (p<0.0001). Comparison of 1- versus 2-year postoperative scores revealed no statistically significant differences for any of the HRQOL parameters.
This study supports the application of HRQOL measures, including the deformity-specific SRS-22, as a valuable tool in the assessment of adult deformity patients. Change in outcome score stabilized after the 1-year postoperative interval, for most patients.
与健康相关的生活质量（HRQOL）测量方法在成人脊柱畸形患者评估中使用得越来越频繁。部分原因是特定于脊柱畸形的脊柱侧凸研究学会-22（SRS-22）得到了验证。因此，HRQOL结果与诸如畸形矫正、融合愈合和并发症等传统成功指标之间的关系正在确立。
研究成人脊柱畸形手术后HRQOL结果反应的模式。
前瞻性多中心队列分析。
283例有术前、术后1年和2年结果测量数据的成人脊柱畸形患者。
SRS-22、简短健康调查问卷-12（SF-12）、奥斯威斯利功能障碍指数（ODI）以及腰腿痛数字评定量表评分。
通过配对样本t检验统计量以及事后方差分析（ANOVA）结果评估术前与术后的健康状况测量指标。
SRS-22评分从基线时的平均3.03分提高到术后6个月的3.21分、1年时的3.71分和2年时的3.70分。ODI平均评分术前为37.0分，术后6个月改善至27.0分，1年和2年时为22.8分。SF-12身体成分评分基线时为33.7分，术后6个月提高到36.9分，1年时为40.6分，2年时为40.5分。比较术后6个月和1年评分的配对样本分析显示，数字评定量表腿痛评分恶化（p = 0.05）。SF-12身体成分评分有改善趋势（p = 0.06）。术后6个月至1年期间，ODI（p = 0.02）和SRS总分（p < 0.0001）有显著改善。比较术后1年与2年的评分发现，任何HRQOL参数均无统计学显著差异。
本研究支持将HRQOL测量方法，包括特定于脊柱畸形的SRS-22，作为评估成人脊柱畸形患者的有价值工具。对于大多数患者，术后1年间隔后结果评分变化趋于稳定。
